Arch Plast Surg.  2019 Nov;46(6):525-534. 10.5999/aps.2019.00661.

Safety and efficacy of transcutaneous bone conduction implant surgery for hearing improvement in microtia patients with bilateral hearing impairment

• Cheon JH
• Lee HC
• Im GJ
• Park JY
• Park C

• KMID: 2465552
• DOI: http://doi.org/10.5999/aps.2019.00661

Abstract

BACKGROUND
In microtia patients with bilateral hearing impairment, hearing improvement is crucial for language development and performance. External auditory canal reconstruction (EACR) has been performed to improve hearing, but often results in complications. We performed transcutaneous bone conduction implant (TBCI) surgery in these patients. This study aimed to evaluate the safety and efficacy of TBCI surgery.
METHODS
A retrospective review was performed of five patients who underwent auricular reconstruction and TBCI surgery and 12 patients who underwent EACR between March 2007 and August 2018. Hearing improvement was measured based on the air-bone gap values using pure-tone audiometry over a 6-week postoperative period. We reviewed other studies on hearing improvement using EACR and compared the findings with our results. The surgical techniques for TBCI were reviewed through case analyses.
RESULTS
Postoperative hearing outcomes showed a significant improvement, with a mean gain of 34.1 dB in the TBCI cohort and 14.1 dB in the EACR cohort. Both gains were statistically significant; however, the TBCI cohort showed much larger gains. Only three of the 12 patients who underwent EACR achieved hearing gains of more than 20 dB, which is consistent with previous studies. All patients who underwent TBCI surgery demonstrated hearing gains of more than 20 dB and experienced no device-related complications.
CONCLUSIONS
TBCI is a safe and effective method of promoting hearing gains in microtia patients with bilateral hearing impairment. TBCI surgery provided better hearing outcomes than EACR and could be performed along with various auricular reconstruction techniques using virgin mastoid skin.

Keyword

Congenital microtia; Ear canal; Hearing loss; Hearing aids; Bone conduction

MeSH Terms

Audiometry, Pure-Tone
Bone Conduction*
Cohort Studies
Congenital Microtia*
Ear Canal
Hearing Aids
Hearing Loss*
Hearing*
Humans
Language Development
Mastoid
Methods
Postoperative Period
Retrospective Studies
Skin